NPIMap

Organization Active NPI

Elite Specialty Clinics, Inc.

Doing business as Elite Health & Fitness

  • Physical Therapy Clinic/Center
  • Williston, ND
National Provider Identifier
1841594900
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1089 Issued in ND
Legal business name
ELITE SPECIALTY CLINICS, INC.
Doing business as
Elite Health & Fitness
Practice address
512 Main St
Williston, ND 58801-5316
Phone
(701) 774-0320
NPI assigned
Jan 4, 2011
Last updated
Jan 4, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Martin John Haug, PT, ATCNPI 1639139405
Title
President/Owner
Phone
(701) 770-0906

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1089 ND Primary

Addresses

Primary practice location

512 Main St
Williston, ND 58801-5316

Mailing address

512 Main St
Williston, ND 58801-5316
Phone (701) 774-0320

Other names 1

  • Elite Health & Fitness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110218000370 ND Part B Supplier - Clinic/Group Practice 7416138870 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
Practice locations: Williston, ND

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Elite Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1841594900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 MAIN ST",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015316",
            "telephone_number": "701-774-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 MAIN ST",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015316",
            "telephone_number": "701-774-0320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SPECIALTY CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "HAUG",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "701-770-0906",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ND",
            "license": "1089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Health & Fitness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.